经皮椎弓根螺钉固定术联合PVP治疗老年胸腰椎骨质疏松爆裂性骨折患者的效果分析

Effect Analysis of Percutaneous Pedicle Screw Fixation Combined with PVP in the Treatment of Elderly Patients with Thoracolumbar Osteoporotic Burst Fractures

目的 探讨经皮椎弓根螺钉固定术联合经皮椎体成形术(Percutaneous Vertebro Plasty,PVP)治疗老年胸腰椎骨质疏松爆裂性骨折患者的效果。方法 回顾性选取2021年1月—2023年12月安溪县医院脊柱外科收治的118例老年胸腰椎骨质疏松爆裂性骨折患者的临床资料,根据治疗方式分为PVP组与观察组。PVP组接受单纯PVP治疗,观察组接受经皮椎弓根螺钉固定术联合PVP治疗。比较两组手术指标、视觉模拟评分法(Visual Analogue Scale,VAS)得分、日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA)评分、Cobb角与椎体前缘高度、并发症发生情况。结果 观察组手术时间为(71.50±6.36)min,术后住院时间为(5.50±1.38)d,长于PVP组,差异有统计学意义(t=27.311、10.935,P均<0.05)。观察组术中出血量为多于PVP组,差异有统计学意义(P<0.05)。术后,观察组VAS评分低于PVP组,Cobb角小于PVP组,JOA评分与椎体前缘高度高于PVP组,差异有统计学意义(P均<0.05)。观察组并发症总发生率低于PVP组,差异有统计学意义(P<0.05)。结论 经皮椎弓根螺钉固定术联合PVP虽然会在一定程度上延长手术与住院时间,增加出血量,但其可提升老年胸腰椎骨质疏松爆裂性骨折治疗效果,减轻术后疼痛感,提升腰椎功能,降低并发症发生风险。

Objective To investigate the effect of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty(PVP) in treating elderly patients with thoracolumbar osteoporotic burst fractures.Methods The clinical data of 118 elderly patients with thoracolumbar osteoporotic burst fractures admitted to the Department of Spine Surgery of Anxi County Hospital from January 2021 to December 2023 were retrospectively selected and divided into the PVP group and the observation group according to the treatment modality.The PVP group received simple PVP treatment,and anterior height of vertebral body,the observation group received percutaneous pedicle screw fixation combined with PVP treatment.The surgical indexes,Visual Analogue Scale(VAS) scores,Japanese Orthopedic Association Scores(JOA) scores,Cobb's angle and the occurrence of complications were compared between the two groups.Results The operation time of the observation group was(71.50±6.36) min,and the postoperative hospitalization time was(5.50±1.38) d,which were longer than that of the PVP group,and the differences were statistically significant(t=27.311,10.935,both P<0.05).The intraoperative bleeding in the observation group was more than that of the PVP group,and the difference was statistically significant(P<0.05).Postoperatively,the VAS score of the observation group was lower than that of the PVP group,the Cobb angle was smaller than that of the PVP group,and the JOA score and the height of the anterior margin of the vertebral body were higher than that of the PVP group,and the differences were statistically significant(both P<0.05).The total complication rate of the observation group was lower than that of the PVP group,and the difference was statistically significant(P<0.05).Conclusion Although percutaneous pedicle screw fixation combined with PVP may prolong the operation and hospitalization time and increase the bleeding to a certain extent,it can enhance the therapeutic effect of elderly thoracolumbar osteoporotic burst fracture,reduce the postoperative pain,improve the lumbar spine function,and reduce the risk of complications.